Bundled payments slash dialysis drug sales

As a physician and nurse have filed a whistleblower lawsuit against dialysis clinic operator DaVita for allegedly overbilling Medicare for medications, changes in Medicare payments have dramatically altered the use of dialysis drugs, reports the New York Times.

According to the lawsuit, DaVita regularly required dialysis care nurses to use the vitamin D boosting drug Zemplar in a single 10 microgram vial for a six microgram dose, rather than smaller doses available in two microgram vials. DaVita would then bill Medicare for the six used micrograms and the four micrograms that went unused. A similar practice was followed for iron supplement drugs such as Venofer, according to the suit.

The suit was filed by Alon Vanier, a former medical director at a DaVita clinic, and Daniel Barbir, a former clinic nurse. The U.S. government declined to join the lawsuit earlier this year, following two years of investigations.

Medicare changed its billing practices at the start of 2011 to bundle drug usage into an overall package of dialysis care, which means firms could not bill for overusing drugs. As a result, sales of blockbuster dialysis drugs such as Epogen have declined 14 percent in the first quarter of 2011, and further declines are expected, notes the Times.

To learn more:
- read the New York Times article
- read the Law.com article
- check out the lawsuit (.pdf)

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